Long-term longevity and clinical outcomes of Linox S/SD implantable cardioverter-defibrillator leads: a single-center experience

Alasti, Mohammad; Machado, Colin; Mirzaee, S.; Healy, S.; Bittinger, L.; Adam, David; Kotschet, Emily; Krafchek, Jack; Alison, J.

doi:10.1007/s10840-020-00787-x

Cited by 3 publications

(1 citation statement)

References 16 publications

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“…The Sprint Fidelis (Medtronic) had been withdrawn before the study recruitment period; the Riata was seldom used in our centers. The Linox (Biotronik) which has been associated with an elevated failure rate in some series 12,13 but not all 7,14 demonstrated similar performance to other models, but the comparison is underpowered.…”

Section: Discussionmentioning

confidence: 99%

Multi‐lead cephalic venous access and long‐term performance of high‐voltage leads

Akhtar

Harding

Elbatran

et al. 2021

Cardiovasc electrophysiol

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Background Cardiac resynchronization therapy‐defibrillator (CRT‐D) implantation via the cephalic vein is feasible and safe. Recent evidence has suggested a higher implantable cardioverter‐defibrillator (ICD) lead failure in multi‐lead defibrillator therapy via the cephalic route. We evaluated the relationship between CRT‐D implantation via the cephalic and ICD lead failure. Methods Data was collected from three CRT‐D implanting centers between October 2008 and September 2017. In total 633 patients were included. Patient and lead characteristics with ICD lead failure were recorded. Comparison of “cephalic” (ICD lead via cephalic) versus “non‐cephalic” (ICD lead via non‐cephalic route) cohorts was performed. Kaplan–Meier survival and a Cox‐regression analysis were applied to assess variables associated with lead failure. Results The cephalic and non‐cephalic cohorts were equally male (81.9% vs. 78%; p = .26), similar in age (69.7 ± 11.5 vs. 68.7 ± 11.9; p = .33) and body mass index (BMI) (27.7 ± 5.1 vs. 27.1 ± 5.7; p = .33). Most ICD leads were implanted via the cephalic vein (73.5%) and patients had a mean of 2.9 ± 0.28 leads implanted via this route. The rate of ICD lead failure was low and statistically similar between both groups (0.36%/year vs. 0.13%/year; p = .12). Female gender was more common in the lead failure cohort than non‐failure (55.6% vs. 17.9%, respectively; p = .004) as was hypertension (88.9% vs. 54.2%, respectively, p = .038). On multivariate Cox‐regression, female sex (p = .008; HR, 7.12 [1.7−30.2]), and BMI (p = .047; HR, 1.12 [1.001−1.24]) were significantly associated with ICD lead failure. Conclusion CRT‐D implantation via the cephalic route is not significantly associated with premature ICD lead failure. Female gender and BMI are predictors of lead failure.

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Section: Discussionmentioning

confidence: 99%

Multi‐lead cephalic venous access and long‐term performance of high‐voltage leads

Akhtar

Harding

Elbatran

et al. 2021

Cardiovasc electrophysiol

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Implantable cardioverter defibrillator lead performance: A systematic review and individual patient data Meta-analysis

Giacopelli¹,

Azzolina²,

Comoretto³

et al. 2023

International Journal of Cardiology

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Performance of an implantable cardioverter‐defibrillator lead family

Klampfleitner

Mundel²,

Schinke³

et al. 2023

Cardiovasc electrophysiol

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Background Lead failure is the major limitation in implantable cardioverter‐defibrillator (ICD) therapy. Long‐term follow‐up data for Biotronik Linox ICD leads are limited. Therefore, we analyzed the performance of all these leads implanted at our institution. Materials and Methods All Linox and Linox Smart ICD leads implanted between 2006 and 2015 were identified. Lead failure was defined as electrical dysfunction (oversensing, abnormal impedance, exit block). Lead survival was described, according to Kaplan–Meier. Associations between lead failure and specific variables were examined. p < .05 was considered significant. Results We included 417 ICD leads. The median follow‐up time for Linox (n = 205) was 81 months and for Linox Smart (n = 212) 75 months. During that follow‐up time, 30 Linox (14.6%) and 16 Linox Smart leads (7.6%) showed a malfunction. The 5‐year lead survival probability was 97.4% for Linox and 95.2% for Linox Smart (log‐rank test, p = .19). The 6‐ and 8‐year lead survival probability for Linox was 93.6% and 84.6%, and for Linox Smart 93% and 91.9%. The only factor significantly associated with lead failure was younger patient age at implantation (hazard ratio/year: 0.97, 95% CI: 0.94–0.99, p = .002). Conclusion This relatively large study with a long follow‐up period highlights a relevant failure rate of Biotronik Linox leads. The performance of Linox versus Linox Smart ICD leads was comparable. Although we show an acceptable 5‐year lead survival probability, we observed a marked drop after just 1 more year of follow‐up. In an era of improving heart failure survival probability, a prolonged follow‐up of ICD leads is increasingly clinically relevant.

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Long-term longevity and clinical outcomes of Linox S/SD implantable cardioverter-defibrillator leads: a single-center experience

Cited by 3 publications

References 16 publications

Multi‐lead cephalic venous access and long‐term performance of high‐voltage leads

Multi‐lead cephalic venous access and long‐term performance of high‐voltage leads

Implantable cardioverter defibrillator lead performance: A systematic review and individual patient data Meta-analysis

Performance of an implantable cardioverter‐defibrillator lead family

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